Provider Demographics
NPI:1225312655
Name:MUNOZ, MARIA ELENA (MS SLP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ELENA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12674 SW 144TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5990
Mailing Address - Country:US
Mailing Address - Phone:786-281-3928
Mailing Address - Fax:
Practice Address - Street 1:8950 SW 152ND ST STE 107
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-2066
Practice Address - Country:US
Practice Address - Phone:786-281-3928
Practice Address - Fax:833-672-2767
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLSA11789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004297700Medicaid